Tie the Knot with Torri: Premarital Counseling Agreement
Pastor Torri Moore, Certified Marriage Counselor, Greensboro, NC 27405 919-523-3953
In order to be fully informed about the certified premarital/marriage counseling you will be receiving, please read through the following agreement.
I am a trained certified premarital counselor and marriage facilitator. However, in some cases I will suggest the counselee also seek a licensed therapist if it requires that course of action.
All information pertaining to our counseling will be held in strict confidentiality; however, there are certain situations in which the counselor is ethically and legally bound to report. The following are exceptions that will result in confidentiality being waived.
The counselor reserves the right to refer you at any time she feels the situation is beyond his ability to properly aid in coming to a resolution. You have the choice to refuse a referral. If you are referred to a licensed therapist you will be given the contact information of the therapist you are being referred to; however, it will be your own responsibility to make an appointment.
If you are referred to a licensed therapist, you can continue with marriage counseling as long as you are also meeting regularly with a license therapist.
Duration of Counseling
Short-term counseling ranges from 1-5 sessions at 1.5 hour per session. Following the first session, the counselor will set the number of sessions, within the 1-5 session range. Issues requiring more extensive care than five sessions will be discussed as needed.
Please be sure to schedule your appointment with the counselor at least one week in advance. If you have an appointment scheduled and need to cancel or reschedule please contact the office of Tie the Knot with Torri as soon as you become aware of this need. There is a $25.00 cancellation fee for all session cancelled less that 24 hours in advance.
Premarital Counseling fees are as follow:
Online SYMBIS Assessment fee is $35.00 per couple (not individual).
In person sessions are $100.00 per 90-minute session.
Virtual Sessions are $50.00 per 90-minute session.
Current Promotions during COVID-19 stay- at- home ord.
Virtual sessions available only at $50.00 per session. Minimum of 4 sessions.
Payments are due at the end of each session via Cash App $torriweds or a Square invoice emailed to client.
Please remit an email address for each client individually, as the SYMBIS assessment must be taken separately without sharing of answers. The counselor will need an email address for the bride/wife and a separate email address for the groom/husband. Once online assessments are fully completed, SYMBIS will notify the counselor and she will reach out to schedule the first session.
Termination of Counseling
You as the counselee have the right to end counseling at any time. However, minimum session payments will still be due.
I also have the right to end our counseling at any time for the following reasons:
§§If my family or I are threatened in any way.
§§If as the counselor I am placed in a potentially compromising position.
§§If the issues of the counselee are deemed to be beyond my scope of abilities.
§§If I believe the counselee is not putting forth effort to do his or her part.
Waiver of Liability
In consideration for receiving premarital counseling and guidance the person receiving counseling agrees to release and waive any and all claims of any kind against Tie the Knot with Torri, and Counselor Torri Moore, arising from or relating to participation in certified premarital/marriage counseling.
Replying to this email with your full names and “We agree” is sufficient to begin virtual sessions at this time.I, the undersigned, have carefully read, understand, and agree to all of the above terms and conditions. I further acknowledge that all the information contained on the following pages is true and complete to the best of my knowledge.
_____________________________________ ______________________________ Signature Printed Name